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Simultaneous management of ipsilateral gonarthritis and ununited tibial stress fracture:Combined total knee arthroplasty and internal fixation

Authors
Journal
The Journal of Arthroplasty
0883-5403
Publisher
Elsevier
Volume
16
Issue
4
Identifiers
DOI: 10.1054/arth.2001.22276
Keywords
  • Stress Fracture
  • Nonunion
  • Tibia
  • Gonarthritis
  • Knee
  • Arthroplasty
Disciplines
  • Medicine

Abstract

Abstract Nonunion of a proximal tibial stress fracture is rare and can be difficult to manage, especially if associated with ipsilateral gonarthritis. Three patients with nonunion of a proximal tibial stress fracture adjacent to an arthritic knee joint were managed by performing simultaneous total knee arthroplasty and internal fixation of the fracture site. The technique involved performing a total knee arthroplasty with angular correction at the site of the extra-articular and intra-articular deformity, bone grafting of the nonunion site, and stabilization of the fracture with a long uncemented intramedullary stemmed tibial component and a unicortical plate. Fibular ostectomy was required during the index surgery in 2 cases to achieve the desired angular correction. In all 3 patients, healing of the nonunion site and limb realignment was achieved. There were no complications or infections associated with the surgery. All patients progressed to full weight bearing at 3 months and had clinical and radiographic union of the nonunion site at 6 months.

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